Dr. D is a relief veterinarian, and clearly is unaffected by the politics of the practice. She just practices the medicine
she was trained to do, and her numbers reflect that. She has the highest performance in radiology, laboratory and the use
of injections for treatment. She is a relatively new graduate, not yet ground down by the bad habits almost all practitioners
form with experience.
"Eyeball diagnosis" has not entered her psyche as yet. "Could be hip dysplasia, so let's throw medicine at it" is not a replacement
for radiology and pre-treatment organ-function evaluation. She is well-respected for her doing things the right way, just
as her education demands. Her dentistry cases are done by another associate because she works only two days a week.
You may note that this analysis shows that a serious medical error is made by all of the professionals, in that wellness testing
is not part of their routine. But 18 percent to 23 percent of all patients are at least seven years of age, and more than
half of their owners are quite amenable to wellness testing. Almost 60 percent of the older patients tested are found to have
subclinical and treatable kidney or liver problems. In addition to the obvious earlier detection of treatable disease, wellness
testing adds about $50,000 a year in profit to any practice with 15 patients a day.
Then there is the serious matter of re-examinations, which I prefer to call "Treatment Progress Evaluation."
We have no guarantee that our initial treatment of most clinical problems will be successful. In fact, the most common cause
of chronic otitis externa is failure of the veterinarian to completely eliminate acute otitis externa. We have a moral obligation
to have the client make a follow-up appointment for most diseases we treat. In this practice, three of the four just are not
scheduling these vital re-examinations, all to the patient's detriment.
There obviously are many more areas of practice that could be benchmarked, but these are the biggies.
The report is posted monthly in the doctor's office area, and each associate can ask himself or herself the necessary questions
as to what each must do to comply with normal standards.
In some cases, management can direct continuing-education emphasis toward dentistry or other areas where more awareness is
But we cannot improve unless we know where improvement is required.
Dr. Snyder, a well-known consultant, publishes Veterinary Productivity, a newsletter for practice productivity. He can be
reached at 112 Harmon Cove Towers, Secaucus, NJ 07094; (800) 292-7995; Vethelp@comcast.net
; fax: (866) 908-6986.